Doctors are earning £1,200 for a single day’s work due to high demand for
out-of-hours GPs.

Some are even being paid bonuses for going out and visiting patients rather than dealing with them over the phone, The Daily Telegraph has discovered.

Senior general practitioners say the sums for being paid for locums represent “a rotten use of NHS resources”, and warn that surgeries are finding it harder and harder to recruit and retain full time staff as a result.

Younger GPs are shunning the traditional route of working their way up in a practice, they say, in favour of locuming which enables them to earn up to £20,000 a month.

Recruitment consultants are blatantly appealing to doctors’ pockets in advertisements for locums, with out-of-hours one of the most lucrative work areas.

In one instance, a recruitment consultancy said out-of-hours GPs would get paid £30 for every consultation they made in person, in addition to an hourly rate of between £70 and £90.

Magazines for GPs regularly carry adverts promising up to £1,200 a shift - with one even touting £1,500.

One is promising those willing to work out-of-hours in Lancashire that they could earn “UP TO £20,000 per MONTH”.

Another, placed on October 24, asked doctors: “Are you a locum GP? You could potentially earn £42,000 for this coming Christmas.”

Carmen Marshall, who runs The Locum GP Consultancy in Luton, Beds., said hourly rates had risen in the past five years because of a paucity of GPs.

“They are more in demand, so they have got the upper hand when it comes to negotiation,” she said.

She said the £1,200 figures tended to be for 12-hour shifts on bank holidays.

But Dr Peter Swinyard, chairman of the Family Doctor Association, which represents more than 1,000 practices, said high fees were a “sticking plaster” for poorly organised out-of-hours services.

“Clearly, it’s a rotten use of NHS resources,” he said.

“But the bottom line is it’s a market and there’s a limited number of people who have the skills for the job and want to do it.”

His surgery in Swindon, Wilts., has recently felt the impact of high rates for locums.

He said: “In my practice we had a really good doctor who we would’ve liked to have kept on.

“But she said, ‘I’m very sorry Peter but you can’t afford me.’

“She said she could earn £91,000 working a 40-hour week as a locum, with a mixture of in-hours and out-of-hours work.”

As a senior partner he said he took home a little more than that - but for that he worked 60 hours a week.

He has been trying to fill a post for a permanent GP since March, so far without success.

“The problem of recruiting doctors who provide continuity of care for their patients is becoming really, really difficult,” he said.

The quality of out-of-hours care, which relies heavily on locums, has come under considerable scrutiny in recent years.

In 2008 David Gray, a 70-year old from Cambridgeshire, died after a German locum mistakenly gave him 10 times the correct dose of a painkiller.

And in September it emerged that out-of-hours services in Cornwall were so stretched that just one GP was responsible for 535,000 people.

Katherine Murphy, chief executive of The Patients Association, said of the shift payments: “To hear of sums of money like this being bandied about, you have to ask ‘Is that an appropriate use of NHS money?’

“Especially when people are having to wait for operations for financial reasons, and we know the NHS has to make £20 billion worth of savings.”

Andy Burnham, the shadow health secretary, said: "There can be no justification for paying footballers' wages to GPs at a time when nursing posts are being lost in their thousands.

"Just as we warned, proper workforce planning is proving to be another victim of the Government's ill-judged decision to dismantle the structures of a successful NHS.

"Regional planning has given way to a local free-for-all and this is resulting in recruitment difficulties in some areas and inflated fees."

Dr Nick Summerton, an East Yorkshire GP, said £80 to £100 an hour for a locum was “about standard nowadays”.

He said: “The real concern I have about the increased use of locums is not the hourly costs but rather the broader impacts on the overall healthcare budget and patient wellbeing.